What is the Data Bank?
The Data Bank brings together all the key messages and key data sources on workforce for adult critical care. The Faculty’s Careers, Recruitment & Workforce Committee has utilised a number of data sources to prepare this workforce document, from FICM Census’ results, recruitment data, CCT output numbers and Consultant appointment data, to data from our critical care partner organisations.
Why was it produced?
The Faculty of Intensive Care Medicine’s (FICM) Careers, Recruitment & Workforce (FICMCRW) has prepared a workforce data pack as a summary for Regional Advisors to use locally to support workforce and recruitment discussions since 2014. Following the recent Critical Engagements report the FICM recognised the essential role that all critical care doctors, nurses, practitioners and Allied Health Professionals have in championing the specialty and its workforce.
The original data pack has therefore been reworked as a public Data Bank and gives a useful summary of the current workforce data and challenges.
How can it be used?
The Faculty will use the resource in its interactions with both local and national and UK-wide healthcare stakeholders. Members of the critical care community are encouraged to use this in discussions with Health Board / Trust management and local commissioners as a standard evidence base for workforce issues. It ensures we are using the same data and same approach in all workforce discussions.
Our thanks to the UK Critical Care Nursing Alliance, CC3N and ACTACC for contributing sections of the Data Bank.
The key messages:
- 3/5 of units do not have a full critical care nursing complement.
- Of those affected, the vast majority considered that bed capacity was inevitably impacted leading to cancelled operations. Quality of care and even patient safety might be impacted.
- 2/5 of units have to close beds due to staffing shortages on at least a weekly basis. Only 14% of units did not have to close beds.
- 4/5 of units had to transfer patients due to lack of beds. With 21% units doing this at least monthly.
- The bed fill rate for Northern Ireland and Wales was estimated to be at least 95%. Scotland was 84%. NHS England data put the critical care bed capacity rate at 87%, but a number of units responded to express doubt that the rate entered for their Trusts was a true reflection of their real capacity.
Dr Carl Waldmann, Dean of the Faculty, said:
“The Faculty of Intensive Care Medicine recommends that the Departments of Health and each Health Board and Trust make modelling of critical care need and resources an urgent priority.”
The Faculty of Intensive Care Medicine was pleased to see the publication of the final report from the Centre for Workforce Intelligence’s (CfWI) review of the Anaesthetic and ICM workforce in February 2015, for which the FICM provided a number of data resources and engaged throughout.
The proposals and comments contained within the In-Depth Review of the Anaesthetics and Intensive Care Medicine Workforce are as follows and are welcomed by the FICM:
- HEE should continue to fill the current number of training posts for anaesthetists and intensivists in England to minimise the risk of short term undersupply. The report notes “HEE may wish to spport the flexibility required to meet the needs of the future workforce by training an appropriate mix of specialists with single and dual CCTs, particularly noting that the future ICM service is likely be delivered mostly by intensivists with Dual CCTs.”
- The report recognises that anaesthetists provide a notable level of service to ICM and that any changes to this provision would need to be counteracted with an increase in the provision of ICM.
- The proposed stocktake of ICM will be undertaken annually through our workforce census, which is currently live.
- The report recognises, in line with ICNARC research on projected usage of Level 2 and 3 bed days, that there is likely to be a significant increase in need over the next 18 years up to 2033, with most scenarios indicating that it is likely to double.
The scenarios are naturally dependent on a number of variables, some less clear than others, including the increasing use of trained and regulated Advanced Critical Care Practitioners, reconfiguration of services, and the impact of the Shape of Training report, but the broad message of the report is one that the ICM community has been aware of for some time: there needs to be more investment in ICM workforce.
Although this report concentrates on England, the FICM continues to look at the wider UK, where we accept the same necessity for growth will be self-evident. The FICM’s Workforce arm has instigated a local engagement plan for the year ahead, starting with a regional review in Wales. These local engagements, coupled with our baseline data (kept up to date through annual censuses), will give us the clearest picture of the future of ICM provision and will allow us to engage on the national stage with the home nation governments and NHS England.
The documents below formed part of the research undertaken for the CfWI Report:
- The implementation of the working time directive and it's impact on the NHS and Health Professionals
- Emergency Medicine: Background to HEE proposals to address workforce shortages
- Literature Review: Critical Care Bed Numbers Per Population Served
- Literature Review: Medical Staffing on Critical Care Units
Health Education England: Call for Evidence
In 2014 and 2015 the FICM submitted evidence to Health Education England as part of their Strategic Framework update. You can view the information for each year by clicking ont he links below.